In an effort to continue to shed light on drug prices and increase transparency, we are excited to present the first ever GoodRx Quarterly Report—an in-depth analysis on the fill trends and drug prices that affect Americans.
This version of the quarterly report mainly focuses on data from the first quarter of 2019 (January 1, 2019 – March 31, 2019).
Among our top findings:
Drugs continue to get more expensive. During the first quarter of 2019, the average list price, the price set by the manufacturer, for all brand and generic drugs increased by 2.9%.
Over 500 brand name medications saw a list price increase in January, 2019.
The 20 most expensive medications in the US all cost more than $25,000 for a monthly supply.
Prices for drugs in New York, Los Angeles and San Francisco were as much as 17% higher than the national average during Q1.
For a full PDF of this report, including a complete breakdown of the methodology, download our white paper here.
The following 10 prescription medications were the most popular during the first quarter of 2019 based on a representative sample of fills at US pharmacies. These drugs are all generics that cost less than $30 for a monthly supply, and paint a picture of the common health issues that Americans face.
Atorvastatin (Lipitor)
Levothyroxine (Synthroid)
Lisinopril (Prinivil, Zestril)
Gabapentin (Neurontin)
Amlodipine (Norvasc)
Hydrocodone/acetaminophen (Vicodin, Norco)
Amoxicillin (Amoxil)
Omeprazole (Prilosec)
Metformin (Glucophage)
Losartan (Cozaar)
The following are the most expensive drugs in the United States, based on their list price—the official price of a drug assigned by the manufacturer. While a majority of these medications treat relatively rare conditions, some—like Remodulin, which treats pulmonary arterial hypertension—target more common conditions. The following 20 drugs are all priced well over $25,000 for a monthly supply.
The 20 most expensive drugs
Drug | Manufacturer | List price |
---|---|---|
Actimmune | Horizon Pharma | $52,322 |
Myalept | Aegerion Pharmaceuticals | $46,328 |
Daraprim | Vyera Pharmaceuticals | $45,000 |
Cinryze | Shire | $44,141 |
Takhzyro | Shire | $44,140 |
Chenodal | Retrophin, Inc | $42,570 |
Juxtapid | Aegerion Pharmaceuticals | $40,671 |
H.P. Acthar | Mallinckrodt Pharmaceuticals | $38,892 |
Tegsedi | Akcea Therapeutics | $34,600 |
Ravicti | Horizon Pharma | $33,572 |
Vitrakvi | Bayer and Loxo Oncology, Inc | $32,800 |
Firazyr | Shire | $32,468 |
Cuprimine | Valeant Pharmaceuticals | $31,426 |
Sovaldi | Gilead | $28,000 |
Viekira Pak | Abbvie | $27,773 |
Viekira XR | Abbvie | $27,773 |
Orfadin | Apotek Produktion & Laboratorier AB | $27,247 |
Tibsovo | Agios Pharmaceuticals | $26,115 |
Cerdelga | Sanofi Genzyme | $26,000 |
Remodulin | United Therapeutics | $25,466 |
For more information on these expensive medications and ways to save, read our blog post here.
Despite continuous effort by lawmakers to ease the rising cost of drug prices, manufacturers continue to increase the prices for their medications.
According to the GoodRx List Price Index, during the first quarter of 2019, the average list price for all brand and generic prescription medications increased by 2.9%, after a huge spike on the during the first week of January.
Every January, a large proportion of manufacturers raise the list prices for their drugs, which explains the large spike in average list price at the beginning of the year. During the first quarter of 2019, over 500 prescription medications saw an increase in list price.
Here are 10 popular drugs that increased in price this past quarter.
Drug | Manufacturer | Percent increase | Price per unit |
---|---|---|---|
Cosentyx | Novartis | 9.9% | $5178.91 per 150 mg/ml syringe |
Entresto | Novartis | 9.9% | $8.49 per 24 mg/26 mg tablet |
Daytrana | Noven Therapeutics | 9.9% | $12.20 per 30 mg patch |
Xtampza ER | Collegium Pharmaceutical, Inc. | 9.9% | $8.32 per 18 mg tablet |
Bystolic | Allergan | 9.7% | $4.87 per 2.5 mg tablet |
Lumigan | Allergan | 9.5% | $78.79 per 2.5 ml eye dropper |
Restasis | Allergan | 9.5% | $101.40 per 5.5 ml bottle of solution |
Xeljanz | Pfizer | 9.4% | $74.68 per 5 mg tablet |
Afrezza | MannKind Corporation | 9.0% | $5.41 per cartridge |
Qnasl | Teva Pharmaceuticals | 9.0% | $26.27 per 80 mcg inhaler |
The large number of drugs that increased in price by over 9.0% is not a coincidence. As the conversation regarding drug prices has heated up over the past couple of years, manufacturers have slowly taken a pledge to keep price increases below 10% annually—but they continue to push the limit and raise prices by 9.9%.
A breakdown of the most popular prescription medications by state reveals an interesting picture of the United States. The most frequently prescribed drug in more than 12 states during Q1 of 2019 was levothyroxine for hypothyroidism, followed by the opioid, hydrocodone/acetaminophen (prescribed most frequently in 11 states), and lisinopril for heart failure (prescribed most frequently in 10 states).
Here’s a breakdown by each drug:
Levothyroxine (most popular in AR, AZ, IA, LA, ME, MT, NV, OR, PA, SD, SA, WY)
Also known as brand-name Synthroid, levothyroxine is a synthetic hormone used to treat hypothyroidism, a condition where the thyroid gland produces low amounts of thyroid hormone. Levothyroxine is continuously one of the most popular medications in the country, with more than 120 million prescriptions written for the drug in the US each year.
Hydrocodone/acetaminophen (most popular in AL, GA, ID, IL, IN, KS, MI, NE, OK, TN, UT)
Even after years of daily headlines about the deadly opioid epidemic and tighter restrictions on prescription fills, opioids are still widely prescribed. Hydrocodone/acetaminophen is the most prescribed pain medication in the US, and is the most popular drug in 11 states.
Lisinopril (most popular in AK, CO, KY, ND, NH, NM, OH, NA, WV, VT)
Lisinopril is a first-line therapy for high blood pressure and heart failure. Since it is relatively affordable and has modest side effects, lisinopril works well for a lot of people. It is the most popular drug in 10 states.
Atorvastatin (most popular in CA, CT, HI, MA, MN, MO, NY, WI)
Atorvastatin was the most frequently filled drug nationwide this quarter, and is the most popular drug in eight states. Used to lower levels of cholesterol and triglycerides to reduce the risk of heart attack or stroke, it is affordable and has few side effects.
Amphetamine salt combo (most popular in DE, SC, DC, RI)
Most commonly referred to as Adderall, amphetamine salt combo is used to treat attention-deficit/hyperactivity disorder, a condition characterized by hyperactivity and impulsivity. Like other medications on this list, amphetamine salt combo has high abuse potential.
Phentermine (most popular in MD, NJ, TX)
Phentermine, also known under the trade name Adipex-P, is used to decrease appetite. While it is the most popular weight loss medication in the US, and the most filled drug in Maryland, New Jersey, and Texas, it is not among the 10 most popular drugs nationwide.
Alprazolam (most popular in FL, MS)
While alprazolam, also known as Xanax, isn’t among the top 10 most popular drugs nationwide, it is the most frequently filled drug in Florida and Mississippi. Used for anxiety, alprazolam is a benzodiazepine, an addictive class of medications mainly used to treat anxiety and panic disorder.
Gabapentin (most popular in NC, VA)
Gabapentin is used to treat seizures in adults with epilepsy and nerve pain. While it is not an opioid, it has recently been linked to misuse and can lead to overdose deaths.
Here’s a breakdown on 10 of the most expensive cities and the 10 of the least expensive cities in the US for drugs:
10 of the most expensive cities for drugs
City | Percent above national average |
---|---|
New York, New York | +16.90% |
San Francisco, California | +14.00% |
Los Angeles, California | +9.90% |
Philadelphia, Pennsylvania | +6.40% |
San Diego, California | +6.20% |
Milwaukee, Wisconsin | +4.50% |
Birmingham, Alabama | +3.30% |
Sacramento, California | +3.20% |
Seattle, Washington | +3.10% |
Little Rock, Arkansas | +2.80% |
10 of the least expensive cities for drugs
City | Percent below national average |
---|---|
Atlanta, Georgia | -20.40% |
Houston, Texas | -19.30% |
Dallas, Texas | -17.50% |
Denver, Colorado | -17.40% |
Cincinnati, Ohio | -12.70% |
Tampa, Florida | -10.70% |
Indianapolis, Indiana | -10.60% |
Salt Lake City, Utah | -8.60% |
Chicago, Illinois | -7.60% |
Detroit, Michigan | -5.70% |
Prescriptions for depression and anxiety medications are on the rise among Americans—and parts of the country appear to be coping with higher rates than others.
In the analysis, we looked at the proportion of depression and anxiety medications filled out of all prescriptions filled during the year (ending March 2019). In most of New England, for instance, depression and anxiety medications accounted for 8% or more of all prescriptions filled, while in California and Texas the fill rate for depression and anxiety medications was just 6%. Nationwide, an average of nearly 7% of filled prescriptions were for anxiety or depression medications, and in much of the country, the proportion of anxiety and depression medications filled has increased in recent years.
Anxiety and depression are closely related but distinct conditions; people coping with these conditions are often prescribed several medications before finding an effective therapy. These medications include commonly prescribed drugs like diazepam (Valium) and alprazolam (Xanax) for anxiety and sertraline (Zoloft) and fluoxetine (Prozac), for both anxiety and depression.
Of all depression and anxiety medications, sertraline (Zoloft) was the most widely filled during the year, accounting for over 4.5% of all prescription fills in some regions. Zoloft is an SSRI (selective serotonin reuptake inhibitor) used to treat depression, anxiety, obsessive-compulsive disorder (OCD), and social anxiety.
Co-contributors: Jeroen van Meijgaard, PhD, Clement B. Feyt, MPH, and Ryan Farrell
For a full PDF of this report, including a complete breakdown of the methodology, download our white paper here.